Centre for Health Services Research, University of Newcastle upon Tyne, Newcastle NE2 4AA

General Practice and Primary Care Research Unit, Cambridge University, Cambridge

Department of Psychology and Behavioural Medicine Research Centre, University of Miami, FL 33124-0751, USA

A growing body of evidence shows how to make behavioural interventions effective

H uman behaviour is a major determinant of health. Factors that influence health related behaviours and people's adaptive responses to disease and illness are becoming better understood. This understanding is leading to behaviourally based interventions targeted at the level of the individual and at service delivery, with impacts on both. Yet there is much more to do. In the United Kingdom the Society of Behavioural Medicine has been set up to promote research into and the use of well founded behavioural interventions.

An example of behavioural interventions working at the individual level is that of psychological preparation of patients facing surgery: procedural information and behavioural instructions reliably reduce the use of analgesia and length of hospital stay.1 Similarly, psychological treatments based on the principles of cognitive behavioural therapy, when compared with alternative active treatments, reduce the experience and expression of chronic pain.2

Behavioural interventions can also trump prescribing in preventing disease: in a rare design comparing behavioural interventions head to head with medication, intensive promotion of physical activity and weight loss reduced the incidence of biochemical diabetes in a high risk group by 58%,3 …